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Related Experiment Videos

Splenic enlargement in neonates during ECMO

D L Klippenstein1, J M Zerin, R B Hirschl

  • 1Department of Radiology, University of Michigan Hospitals, Ann Arbor.

Radiology
|February 1, 1994
PubMed
Summary

Neonates undergoing extracorporeal membrane oxygenation (ECMO) for respiratory failure often experience spleen enlargement. This rapid splenic growth during ECMO is likely due to the sequestration of damaged blood cells.

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Area of Science:

  • Pediatric critical care medicine
  • Neonatal physiology
  • Cardiopulmonary support

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life support system for neonates with severe respiratory failure.
  • Hepatosplenomegaly, an enlargement of the liver and spleen, is a potential complication in critically ill patients.

Purpose of the Study:

  • To investigate if hepatosplenomegaly is a consistent finding in neonates treated with ECMO.
  • To quantify splenic and hepatic size changes during ECMO therapy.

Main Methods:

  • Ultrasound (US) was used to measure splenic and hepatic dimensions in seven neonates.
  • Measurements were taken at ECMO initiation and every 24-48 hours until decannulation.
  • Splenic volume and hepatic size index were calculated using established formulas.

Main Results:

  • All seven neonates showed a significant increase in splenic volume (from 8.3 cm³ to 16.4 cm³; P < .001).
  • Hepatic size did not exhibit significant changes during ECMO.
  • The spleen's enlargement was rapid and consistent across all patients.

Conclusions:

  • Rapid splenic enlargement in neonates on ECMO may result from the sequestration of damaged red blood cells, platelets, and other hematologic elements.
  • The lack of concurrent liver enlargement suggests that splenic growth is not due to passive congestion.
  • These findings highlight a specific hematologic consequence of ECMO in neonates.

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